Better than gold

Although expensive, donor breast milk is a blessing for moms who need it

Robin Huiras

8/31/09 2:42 PM

While her daughter was a patient at Illinois Masonic Medical Center’s neonatal intensive care unit, Rosemary Bubnis pumped her breast milk so Raisa, born six weeks early and initially unable to nurse, could reap the benefits of her milk.

During those three weeks last year, the Roscoe Village resident befriended the other NICU moms and watched many of them, whose premature infants had been in the hospital for extended periods, struggle to produce enough milk to feed their children.

"To see moms who want to breastfeed and can’t, it’s so sad," says Bubnis, whose own supply filled enough bottles to stock her freezer. "These moms could not believe how much milk I came back with from the pump rooms and we joked that if I had any left over I would love to give and they to have it."

When Raisa was discharged and began to nurse, Bubnis was left with a freezer full of bottles and memories of mothers desperate to provide their babies breast milk.

"I really wanted to donate it because to me, it was precious," she says. "I was blessed with so much of a supply, and from watching Raisa develop (at her 4 ½ month checkup she was in the 90th percentile) I figured there must be something in the milk good for her, so why not share that with other babies in need."

Bubnis’ search led her to the Indianapolis-based Indiana Mothers’ Milk Bank Inc., one of 11 comprising the nonprofit Human Milk Banking Association of North America (there is currently no milk bank in Illinois).

Since opening in August 2005, more than 400 women have made donations, says Donna Miracle, a registered nurse and director of research and clinical operations. Each month, between 3,000 and 4,000 ounces of milk are processed and distributed to individuals and hospitals in Indiana, Illinois and Missouri.

"The process was insanely time consuming and the dry ice (for shipping) was hard to come by, but I still felt like this was a gift I needed to utilize," she says.

In 2005, 54 percent of the donated milk was distributed to premature infants in neonatal intensive care units; 5 percent to families with adopted children; 8 percent to babies with failure to thrive; and 18 percent to babies whose own mothers were unable to provide their own, according to the milk bank association.

"As the science of human milk expands and we learn more about what happens over the life span in terms of disease processes, it raises the need for donor milk," Miracle says.

Not only has breast milk been found to have short-term nutritional and immunological value, its benefits have been tied to reducing Type 2 diabetes, obesity and cardiovascular illness.

Donor milk is second best to mother’s own, says Paula Meier, director for Clinical Research and Lactation at the Neonatal Intensive Care Unit at Rush University Medical Center.

"To say that the benefits that exist in mother’s own also exist in donor milk, we don’t know that," Meier says. "Chances are some of them do, but donor milk is pooled and pasteurized and in that process a lot of things are affected."

Until a comprehensive study examines the cost effectiveness of donor milk, it’s impossible to place value on donor milk programs, she says. Such a study might look at whether babies who received donor milk developed fewer cases of bottle-related complications. If conclusive, the study might compel insurance companies to cover the $4 per ounce fee.

"Of course, the whole idea is that a mother is giving something for another baby, but the scientist always wants to say it’s not enough to feel good," Meier says. "Milk banking is expensive, there’s a lot in processing and shipping costs, so before we embrace something we really have to know that it makes a difference."

Nonetheless, Meier encourages members of The Rush Mothers’ Milk Club, established in 1996, to donate their excess milk and Rush regularly ships donations to the Indiana Mothers’ Milk Bank and Mothers’ Milk Bank at Austin, Texas.

Cost effectiveness aside, simply having the option of donor milk is of value, Miracle says.

"This offers nurses and physicians a tool to empower mothers, giving them a decision-making power in a situation where they have little choice over what is being done for their babies," she says.

Such was the case for Molly Sullivan, who knew her daughter Lauren—born through surrogacy at just 25 weeks—would need the best of everything to survive.

"At the hospital, I would see moms come in with their coolers of frozen breast milk and I thought, ‘God, I wish I could do that for her,’ " says Sullivan. "The doctors said there were no specific studies and that formula was fine, and I don’t know if it was mother’s instinct, but I was determined that donor milk was what I wanted."

Sullivan’s online search lead her to the Indiana Mother’s Milk Bank. She discovered Lauren would need a doctor’s prescription and they had to pay the $4 an ounce fee—a cost that doesn’t completely cover processing, bank directors say.

At $12 a bottle, Sullivan says she and her husband John spent several thousand dollars for the milk.

"I don’t know if I can say it saved her life, but it was a huge part of how she thrived and grew. One of the nurses couldn’t believe that she was laughing and cooing and hitting all of the milestones for a baby of six weeks and I have to believe that a part of that was what she ate."

Breast milk banking facts

• In 1945 the first nonprofit bank was founded in Delaware.

• In 1985 the Human Milk Banking Association of North America was founded.

• In 2005 the 11 Human Milk Banking Association of North America banks sent 745,329 ounces of milk to hospitals and individuals in 80 cities in 29 states and three Canadian provinces.

• From 2000 to 2005, the amount of milk distributed by HMBANA has increased by 45 percent.

Donors must:

• Complete a medical history and undergo a simple blood test, which screens for HIV, HTLV, syphilis and Hepatitis B and C.

• Be willing to donate at least 100 ounces of milk. They receive no compensation.

• Not take medication or herbal supplements, nor use illegal drugs or tobacco.

• Consume less than two alcoholic beverages daily.

• Not be at risk for HIV.

• Undergo simple training on storing and shipping their milk and will receive all requisite materials, with the exception of dry ice, to ship their donations.

At the bank:

• Donations from several sources are transferred and mixed together in larger flasks.

• The pooled milk is poured into 4-ounce bottles.

• The bottles are pasteurized by being placed in a shaking water bath heated to nearly 145 degrees. This process destroys bacteria while retaining most of the milk’s beneficial components.

• The milk is lab-tested and cultured to test for bacterial growth. Contaminated milk is discarded.

• Pasteurized milk is frozen at the banks. When orders arrive, the bottles are shipped overnight to hospitals or individuals.